Possible nosocomial transmission of group B streptococci in a newborn nursery

Within a six-day period in March, 1974, three infants born at a hospital in central Arkansas developed meningitis caused by group B, type III Streptococci. Three factors suggested nosocomial transmission of the organism in the nursery: (1) the three infants were born in a six-day period, (2) four weeks after their infants' births, none of the parents had positive cultures for group B streptococci, and (3) 31% of infants born in the hospital in March were colonized with group B, type III streptococci, while in April, after control measures in the nursery were instituted, only 2% of infants were colonized with this type (p less than 0.0002). Colonized infants were treated with penicillin, but follow-up cultures at two and six weeks showed that half the infants tested were still colonized. The number of personnel colonized with group B streptococci was not significantly different in personnel exposed to infants when compared with those that were not, and handwashing and environmental cultures were negative for group B streptococci. The results of this investigation give additional support to the concept that nosocomial transmission of group B streptococci can occur and may be effectively interrupted by control measures in the nursery.